1922073774 NPI number — PEOPLE INC

Table of content: (NPI 1922073774)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922073774 NPI number — PEOPLE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PEOPLE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ELMWOOD HEALTH CENTER, PEOPLE INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922073774
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2128 ELMWOOD AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14207-1910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-874-4500
Provider Business Mailing Address Fax Number:
716-874-3195

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2128 ELMWOOD AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14207-1910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-874-4500
Provider Business Practice Location Address Fax Number:
716-874-3195
Provider Enumeration Date:
02/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KORUS
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
H
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
716-874-4500

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  1401228R , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 33D00881570 . This is a "CL/A" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01465154 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com